Psychiatry of the elderly

Author(s):  
Philip Cowen ◽  
Paul Harrison ◽  
Tom Burns

When considering psychiatric disorder in the elderly, the clinician must be able to collect and integrate information from a variety of sources, and produce a management plan which takes account of physical and social needs, as well as psychological ones. This plan is likely to involve the cooperation of several professionals. It is in this clinical complexity that much of the challenge and fascination of old age psychiatry lies. Chapter 18 deals with the psychiatry of old age, with two important exceptions, both of which were covered in Chapter 13: delirium, and the clinical features, aetiology, and investigation of dementia.

2005 ◽  
Vol 45 (2) ◽  
pp. 154-160 ◽  
Author(s):  
I O Nnatu ◽  
F Mahomed ◽  
A Shah

The population of the elderly in most developed nations is on the increase. Furthermore, the prevalence of mental disorder amongst elderly offenders is high. The true extent of `elderly' crime is unknown because much of it goes undetected and unreported. This leads to a failure to detect mental illness in such offenders. Court diversion schemes may improve recognition of mental illness but these schemes usually tend to deal with the more severe crimes. This may result in an overestimation of the amount of serious crime committed by the elderly and a failure to detect mental illness amongst those who commit less serious crimes. Efforts to service this hidden morbidity call for multi-agency collaboration. Improved detection and reporting of crimes is essential if mental health difficulties in the elderly are not to go unnoticed. The needs of elderly mentally-disordered offenders are complex and fall within the expertise of old age and forensic psychiatry, without being adequately met by either one. Therefore, consideration should be given to the development of a tertiary specialist forensic old-age psychiatry service.


2002 ◽  
Vol 8 (4) ◽  
pp. 271-278 ◽  
Author(s):  
Brian Murray ◽  
Robin Jacoby

This article aims to provide a practical overview concentrating on civil legal aspects of psychiatric care for the elderly. We limit ourselves to English law (which also has jurisdiction in Wales; Scottish and Northern Irish law may be similar, but not identical). Civil law can, in turn, be divided into statute law (legislation provided by Parliament) and common law (the UK, unlike some European countries, has a strong tradition of law based on previous rulings by judges).


1992 ◽  
Vol 16 (10) ◽  
pp. 612-613
Author(s):  
Stephen Dover ◽  
Christopher McWilliam

The co-existence of physical and psychiatric illness in so much of the elderly population poses diagnostic and therapeutic problems for psychiatrists, geriatricians and general practitioners alike, with the presence of physical illness strongly influencing and sometimes limiting the options for treatment of the psychiatric illness. Recognition of this has resulted in the Section of Old Age Psychiatry of the Royal College of Psychiatrists recommending that senior registrar training in old age psychiatry should include a one month attachment to an approved geriatric medicine unit.


1991 ◽  
Vol 15 (1) ◽  
pp. 15-16
Author(s):  
Dawn Black ◽  
Elspeth Guthrie ◽  
David Jolley

The old age psychiatrist's role has been evocatively described as “physician to the soul of the elderly”. A more practical definition is psychiatrist to patients over the age of 65 with both functional and organic illnesses.


1989 ◽  
Vol 155 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Susan M. Benbow

Electroconvulsive therapy is an important treatment in the depressive states of late life, and there is general agreement about the indications for its use in old age psychiatry. Indeed, old age may be associated with a better response to ECT than that in younger age groups. The additional risk involved through physical problems in the elderly is not great when compared with that of continuing depression and of the side-effects of alternative treatments. Temporary memory disorders and confusion may occur, but are minimised if unilateral electrode placement is used. Some patients treated with unilateral ECT do not respond, but will respond to bilateral treatment. Anxiety over unwanted treatment effects, which can lead to ineffective treatment of depressive illness, must be outweighed by knowledge of the dangers of leaving depression untreated in old age.


1994 ◽  
Vol 18 (9) ◽  
pp. 541-544 ◽  
Author(s):  
Catherine Oppenheimer ◽  
Gwen Adshead ◽  
Jeanette Smith

Patients and their relatives sometimes make what to others appear to be unfortunate decisions. In this paper the ethical dilemmas raised by such decisions in the context of old age psychiatry are examined. The case also raises questions about financial responsibility for the care of the elderly and suggests that the health needs of patients can no longer be separated from their financial interests.


1998 ◽  
Vol 4 (3) ◽  
pp. 183-185 ◽  
Author(s):  
Stephen Curran ◽  
Peter C. W. Bowie

There are many different course designs for the teaching of old age psychiatry. It may be taught in blocks or spread over the undergraduate curriculum and/or integrated with either psychiatry or medicine for the elderly. Whichever approach is used, at the end of their undergraduate training, students should have the same core knowledge, skills and attitudes.


2020 ◽  
Vol 10 (1) ◽  
pp. 169-184
Author(s):  
Menuka Bhandari ◽  
Alweena Niroula ◽  
Shamila Chaudhary

Nepal is also witnessing the expansion of life span and hence an enhancement in the population of the elderly. In Nepal, individuals over 60 years of age are considered elderly. According to the 2011 census of Nepal, there were 2.1 million elderly inhabitants, which constitute 8.1percent of the total population in the country. Pashupati Bridrashram the only one shelter for elderly people run by the government which was established in 1976 as the first residential facility for elders. This study was conducted to assess the health and social needs of elderlyresiding at Birateshwor Briddhashram and Mahila Jagriti Briddhashram Biratnagar. Descriptive cross sectional research design has been used to describe characteristics of apopulation. There are four registered old age home in Biratnagar Metropolitan City, amongthem only two were selected purposively. Non random sampling technique has been used in which Purposive Sampling method has been adopted. Both health and social needs we reassessed using semi-structured interview schedule which consisted of multiple response questionnaire. There were fifty-seven elders, only forty were selected purposively who can give their information, twenty-four females and sixteen males were selected for interview. Most of the elders came to old age home because of lack of own shelter, sixty percent elders have no any children; mostly they were widow or widower. Majority of them had vision (60 %), walking (46%), hearing problems (33 %) and minority (10 %) have inability problems in moving extremities, difficulty in talking. Only a few elders came there because of maltreatment by their family members. The study has suggested for establishment of health post or healthcare center, provision of ambulance to meet their health needs and importance of care taker to make their life easier, provision of television, kitchen garden, temple to meet their social and spiritual needs.


1997 ◽  
Vol 14 (1) ◽  
pp. 4-7 ◽  
Author(s):  
Aideen Freyne ◽  
Margo Wrigley

AbstractObjective: This study reviewed all inpatient admissions in a community oriented old age psychiatry service with the aim of assessing the appropriateness of admission criteria, obtaining a profile of those admitted, and providing information about service utilisation.Method: A retrospective chart review of all first inpatient admissions from 1989-1993 was carried out. Information concerning sociodemographic and clinical variables, and outcome measures in terms of discharge destination, was obtained.Results: There were 205 first admissions in the study period. There were 37 patients (18%) admitted on an involuntary basis. One per cent of admissions were not assessed at home prior to admission. Six patients had no formal psychiatric disorder, of the remainder 53% had an organic, and 47% a functional psychiatric disorder. Of those admitted 68% were discharged to their original destination. Patients with dementia were more likely to be discharged to nursing homes. Other discharge destinations were also used.Conclusions: The policy of initial domiciliary assessment of all referrals prior to admission is feasible in the majority of cases. Defined admission criteria clarify reasons for admission, and ensures appropriate use of beds. The range of discharge destinations highlights the need for maintaining close ongoing links with other service providers.


2005 ◽  
Vol 22 (3) ◽  
pp. 103-106 ◽  
Author(s):  
Sharon Foley ◽  
Aideen Freyne

AbstractWith advancements in medical science over past decades, our aging population has increased substantially. Census studies in 2001 showed that 429,100 of the population of the Republic of Ireland were aged 65yrs and older, making up 11.2% of the overall population. While the overall population of the Republic is expected to remain stable over the next ten years, the demographic projections for the elderly population is for significant growth: numbers of over 65yrs are expected to increase by nearly 108,000 people between 1996 - 2011, comprising over 14.1% of the overall population. In particular, our communities will contain a much higher proportion of octogenarians and nonagenarians: at present 21% of our over 65's are 80 yrs or older; by 2011, it is projected that this number will increase to 25%. In tandem, the prevalence of dementia will increase.In 2000, it was estimated that 31,000 people suffered with dementia in the Republic of Ireland, and this figure is expected to increase by 5000 cases per year between 2001-2011. The ultimate outcome of this demographic shift, will be higher demands on medical services for older people, especially geriatric medicine and old age psychiatry. This paper will focus on two particular aspects of management which will increasingly impact on the work of old age psychiatrists – medicolegal issues and management issues in dementia.


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